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Wednesday, April 16, 2014

Evidence-based or Shmevidence-based

The fitness industry is currently at war. It’s the evidence-based guys versus the bro scientists, and both sides will stop at nothing to shove their methodology down your throat.

The war is over how best to consolidate science and practice. The evidence-based camp evaluates the entire body of knowledge in order to form an opinion on an issue. In hierarchical order by level of evidence, this includes all meta-analyses, review papers, randomized clinical trials, and case studies on the topic. After all these options have been exhausted, expert opinion and anecdotal evidence are considered.Meanwhile, bro scientists don’t feel the need to wait around for the lab coats to tell them what they already know. In order to form their opinions, they generally pick from the bottom rungs of the evidence ladder (anecdotes and expert opinion), often shunning real science in favor of guruism. They feel that their own experience, based on decades of work with thousands of real people, is superior to any laboratory study. The evidence-based approach excels in its acknowledgement and avoidance of biases in search of deeper truths, like the mechanisms behind why particular practices works. The bro scientists, on the other hand, are typically content with an ‘if it works, it works’ mentality, even as new research flies in the face of their age-old, tried-and-true practices.The scientific method is not without its shortcomings, however, and anyone who calls themselves “evidence-based” had better recognize its limitations. Statistics lie. Authors of reviewer papers are not without bias. External validity, or the degree to which the findings of a study can be generalized, can be suspect. That is, just because something worked in the lab setting with a specific target population does not guarantee it can be applied equally well out on the gym floor to another group of people.Furthermore, say, for instance, a study compares two different types of training and shows no difference between the two. What this really means is that, on average for a group of people, the two types of training do not differ significantly. What this doesn’t mean, though, is that one type of training wouldn’t necessarily be better for a particular individual. This individual variation is exactly what makes training an art in addition to a science.Both sides of this battle clearly have their strengths and their weaknesses. Likewise, they each tend to get carried away with their own approach -- the evidence-based practitioners demanding that every claim be backed by a peer-reviewed journal article (or three) and the bro scientists selectively ignoring high-quality research if it contradicts their own strongly held views.While both the evidence-based and bro science approaches have their imperfections, neither extreme should be foolhardily rejected nor embraced. The more sensible approach is to take the middle ground -- to merge the science and the art. The good news? Industry leaders like Alan Aragon, Bret Contreras, Brad Schoenfeld, and Nick Tumminello are doing just that – fusing their knowledge and keen understanding of the science with their own decades of experience in order to inform on practicable gym floor applications.

Here are a few ways we can take cues from these scholarly individuals:

Considering all the levels of evidence, not just the highest or the lowest.

Being simultaneously open-minded yet skeptical. We must consider viewpoints besides our own, while also taking everything with a grain of salt, no matter how smart or credentialed the informant.

Reading the scientific papers (entire papers, not just abstracts!), assessing the merits and limitations of the studies, and coming to our own conclusions. We can’t simply take someone else’s word for it.

Gathering information from a variety of sources, not just one or two of our favorite fitness professionals. Expert opinion is just that: opinion. Plus, even the experts disagree, so it’s vital to expose ourselves to multiple perspectives, not just the ones we always seem to agree with.

Trying everything out -- first on ourselves, and then on our clients -- before pronouncing anything bunk. Only after embracing something completely can we be certain as to whether or not it really works.

By following these steps, we may one day end this ugly war and seamlessly intertwine the science and art of training.